Splinting vs temporary external fixation in the initial treatment of ankle fracture-dislocations

2021 ◽  
Author(s):  
Mehmet Ozbey Buyukkuscu ◽  
Seckin Basilgan ◽  
Ali Mollaomeroglu ◽  
Abdulhamit Misir ◽  
Hakan Basar
Keyword(s):  
External Fixation ◽  
Initial Treatment ◽  
Ankle Fracture ◽  
Fracture Dislocations

A new approach to local DCO in ankle fracture dislocations: external fixation with diaphyseal unicortical screws applied by local anaesthesia

2017 ◽  
Vol 101 (3) ◽  
pp. 229-235 ◽  
Author(s):  
F. Lavini ◽  
T. Maluta ◽  
G. Carpeggiani ◽  
C. Dall’Oca ◽  
E. Samaila ◽  
...  
Keyword(s):  
External Fixation ◽  
Local Anaesthesia ◽  
Ankle Fracture ◽  
New Approach ◽  
Fracture Dislocations

Temporizing External Fixation vs Splinting Following Ankle Fracture Dislocation

2019 ◽  
Vol 41 (2) ◽  
pp. 177-182
Author(s):  
Richard A. Wawrose ◽  
Leonid S. Grossman ◽  
Matthew Tagliaferro ◽  
Peter A. Siska ◽  
Gele B. Moloney ◽  
...  
Keyword(s):  
External Fixation ◽  
External Fixator ◽  
Closed Reduction ◽  
Ankle Fracture ◽  
Skin Necrosis ◽  
Fracture Dislocation ◽  
Level Of Evidence ◽  
Increased Risk ◽  
Loss Of Reduction ◽  
Fracture Dislocations

Background: Closed reduction and splinting followed by outpatient management is standard of care for temporizing most ankle fractures. However, ankle fracture-dislocation potentially warrants a different approach based on the propensity for loss of reduction. The purpose of this study was to determine the rate of complications associated with closed reduction and splinting of unstable ankle fracture-dislocations. Further, we sought to determine the efficacy of immediate external fixation as an alternative to splinting in cases too swollen for acute operation. Methods: This retrospective chart review analyzed all ankle-fracture dislocations that came through a large health care system from 2008 to 2018. Patients managed with acute open reduction internal fixation (ORIF) and open fractures were excluded. In patients managed late, the cohorts were divided into those temporized with closed reduction/splinting vs external fixation. Reduction quality and splint technique were additionally assessed in splinted patients. A total of 354 closed ankle fracture-dislocations were identified: 298 patients (84%) underwent ORIF within 48 hours and were excluded; 28 (15 female/13 male, average age 46.8 years) were placed in an external fixator and 28 (22 female/6 male, average age 57.2 years) were reduced, splinted, and discharged. Results: At follow-up, 14 of the patients (50%) in the splint group developed loss of reduction and 5 of these patients (17.6%) developed anteromedial skin necrosis from skin tenting. None of the patients in the ex-fix group developed loss of reduction or skin necrosis. The rate of redislocation and the rate of development of skin necrosis was statistically higher in cases temporized with a splint versus an external fixator ( P < .01 and P = .05, respectively). Conclusion: We found that in ankle fracture-dislocations not treated with acute ORIF, splint immobilization was associated with an increased risk of complications, including redislocation and skin necrosis, when compared to a temporizing external fixator. Level of Evidence: Level III, retrospective comparative study.

Volar plating versus external fixation for unstable dorsal fracture-dislocations of the proximal interphalangeal joint

2021 ◽  
pp. 175319342110593
Author(s):  
Atsuhiko Murayama ◽  
Kentaro Watanabe ◽  
Hideyuki Ota ◽  
Shigeru Kurimoto ◽  
Hitoshi Hirata
Keyword(s):  
External Fixation ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Volar Plating ◽  
Distal Interphalangeal Joint ◽  
Active Flexion ◽  
Plate Group ◽  
Fracture Dislocations ◽  
Distal Interphalangeal

We retrospectively compared the results of volar plating and dynamic external fixation for acute unstable dorsal fracture-dislocations of the proximal interphalangeal joint with a depressed fragment. We treated 31 patients (31 fingers), 12 with volar buttress plating and 19 with dynamic external fixation. Follow-up averaged 35 and 40 months in the two groups, with a minimal 6-month follow-up. Average active flexion of the proximal interphalangeal joint was 95° after plate fixation and 87° after external fixation, with an active extension lag of –6° and –9°, respectively. Active flexion at the distal interphalangeal joint averaged 67° in the plate group and 58° in the external fixation group, with active extension lags of 0° and –5°, respectively. We conclude that both methods can obtain a good range of motion at the proximal interphalangeal joint. A limitation of the extension of the distal interphalangeal joint occurred with dynamic external fixation but not with volar buttress plating. Level of evidence: IV

Functional Outcomes After Fracture-Dislocation of the Ankle

2019 ◽  
Vol 13 (1) ◽  
pp. 18-26 ◽  
Author(s):  
Direk Tantigate ◽  
Gavin Ho ◽  
Joshua Kirschenbaum ◽  
Henrik C. Bäcker ◽  
Benjamin Asherman ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Functional Outcomes ◽  
Ankle Fracture ◽  
Statistical Significance ◽  
Ankle Fractures ◽  
Fracture Dislocation ◽  
Wound Complications ◽  
Pain Subscale ◽  
Fracture Dislocations

Background. Fracture dislocation of the ankle represents a substantial injury to the bony and soft tissue structures of the ankle. There has been only limited reporting of functional outcome of ankle fracture-dislocations. This study aimed to compare functional outcome after open reduction internal fixation in ankle fractures with and without dislocation. Methods. A retrospective chart review of surgically treated ankle fractures over a 3- year period was performed. Demographic data, type of fracture, operative time and complications were recorded. Of 118 patients eligible for analysis, 33 (28%) sustained a fracture-dislocation. Mean patient age was 46.6 years; 62 patients, who had follow-up of at least 12 months, were analyzed for functional outcome assessed by the Foot and Ankle Outcome Score (FAOS). The median follow-up time was 37 months. Demographic variables and FAOS were compared between ankle fractures with and without dislocation. Results. The average age of patients sustaining fracture-dislocation was greater (53 vs 44 years, P = .017); a greater percentage were female (72.7% vs 51.8%, P = .039) and diabetic (24.2% vs 7.1%, P = .010). Wound complications were similar between both groups. FAOS was generally poorer in the fracture-dislocation group, although only the pain subscale demonstrated statistical significance (76 vs 92, P = .012). Conclusion. Ankle fracture-dislocation occurred more frequently in patients who were older, female, and diabetic. At a median of just > 3-year follow-up, functional outcomes in fracture-dislocations were generally poorer; the pain subscale of FAOS was worse in a statistically significant fashion. Levels of Evidence: Therapeutic, Level III

Intra-Articular Block Compared with Conscious Sedation for Closed Reduction of Ankle Fracture-Dislocations

2008 ◽  
Vol 90 (4) ◽  
pp. 731-734 ◽  
Author(s):  
Brian J. White ◽  
Michael Walsh ◽  
Kenneth A. Egol ◽  
Nirmal C. Tejwani
Keyword(s):  
Closed Reduction ◽  
Ankle Fracture ◽  
Conscious Sedation ◽  
Fracture Dislocations

Static and Dynamic External Fixation are Equally Effective for Unstable Elbow Fracture-Dislocations

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Saad AlQahtani ◽  
William R. Aibinder ◽  
Joshua A. Parry ◽  
Anna Seltser ◽  
George S. Athwal ◽  
...  
Keyword(s):  
External Fixation ◽  
Elbow Fracture ◽  
Fracture Dislocations ◽  
Unstable Elbow
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